Phenotyping Interstitial Cystitis Patients to Match Therapies - Robert Moldwin

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Phenotyping Interstitial Cystitis Patients to Match Therapies - Robert Moldwin

https://www.urotoday.com/video-lectures ... ldwin.html

Robert Moldwin presents a phenotyping framework for interstitial cystitis/bladder pain syndrome, proposing that matching therapy to the dominant pain generator improves outcomes in this heterogeneous population. He identifies four clinical phenotypes: bladder-centric with or without visible inflammation, high-tone pelvic floor dysfunction, and widespread centralized pain. Patients with pelvic floor tenderness are directed toward physical therapy and muscle relaxants before cystoscopy; those with centralized pain toward tricyclics or gabapentinoids; and those with bladder-centric features toward intravesical therapies or hydrodistension. Physical examination consists of a single-finger assessment of levators and obturator internus bilaterally to identify banding, tone, and pain reproduction, followed by an anesthetic challenge at cystoscopy to confirm bladder centricity.